‘We no longer die in childbirth’: how Indian villages saved their mothers

 

Powered by Guardian.co.ukThis article titled “‘We no longer die in childbirth’: how Indian villages saved their mothers” was written by Amrit Dhillon in Amethi, India, for theguardian.com on Tuesday 12th June 2018 09.30 Asia/Kolkata

The message is written on a poster, hung between trees that offer shade but little relief from the blazing sun. It spells out what has been achieved in this rural Indian village: “We no longer die in childbirth.”

For the women of Purabgaon, in the Amethi district of Uttar Pradesh, expectations had always been clear. Get married young, then have back-to-back pregnancies. Those babies would be delivered in unsanitary conditions at home by a dai, a village midwife with no training and many superstitions.

“Even if a woman was taken to hospital for the birth, half an hour later she would be bundled home to do the chores, feed the cattle and cook,” said Gulab Yadav, a project manager in Amethi for Save a Mother.

The maternal mortality rate (MMR) in Amethi has been one of the highest in the world – 451 deaths per 100,000 live births, according to a 2008 government survey. Anaemia is one key problem: around 55% of Indian women are anaemic, and rural women’s diets are often poor.

Save a Mother aims to educate rural women about pregnancy, nutrition, immunisation, delivery and care of the child. “We told them to delay having the first baby and leave a three-year gap between pregnancies to keep mother and child safe and healthy. And they understand that delivery in hospital is safest because complications such as heavy bleeding can be treated,” said Gita Gupta, a Save a Mother team leader.

Gupta leads a group of 20 female “change agents” in Purabgaon. Each of the 360 villages in Amethi covered by the scheme has a team of 20 agents – local women trained to educate other women.

Gupta sometimes changes the lyrics of romantic folk songs to refer to iron supplements, intrauterine devices (IUDs) and breastfeeding. “They find it easier to remember what I’ve told them if they sing it,” she said.

 

News doesn’t always have to be bad – indeed, the relentless focus on confrontation, disaster, antagonism and blame risks convincing the public that the world is hopeless and there is nothing we can do.

This series is an antidote, an attempt to show that there is plenty of hope, as our journalists scour the planet looking for pioneers, trailblazers, best practice, unsung heroes, ideas that work, ideas that might and innovations whose time might have come.

Readers can recommend other projects, people and progress that we should report on by contacting us at theupside@theguardian.com

 

  
Sign here for weekly emailed updates from this series

Beginning with 20 villages in Amethi 10 years ago, Save a Mother has expanded to 1,100 villages in the states of Uttar Pradesh, Karnataka and Telangana. The maternal mortality rate for those villages has been reduced by 90% and infant mortality is down by 60%.

Last year in Purabgaon, not a single mother died in childbirth. Nationwide there are five maternal deaths in childbirth every hour, but the mortality rate has been falling steadily, from 280 per 100,000 live births in 2005 to 174 in 2015 and 130 in 2016.

Shiban Ganju, a Chicago-based doctor, founded Save a Mother after a visit to rural Uttar Pradesh. “As a physician I knew [the high mortality rate] could be solved by a dedicated group working with the community,” he said.

Ten years on, he said he had learned two key things. Firstly, that changing social behaviour is the most effective and least expensive way to reduce the impact of disease. And secondly, that the Indian government should increase its public health spending from the current 1.1% of GDP – one of the lowest proportions in the world – to 2.5%.

Some of the older women in Purabgaon talked candidly about the relentless pressure they were put under to give birth. “I had five children in quick succession, my mother-in-law kept saying she wanted a grandson. Then I married off my eldest daughter at 15. That was wrong,” said Urmila Devi. “I know better now. My youngest girl won’t get married before 20 and I will tell her to control her pregnancies.”

The village remains highly conservative, but the project has had an impact: many women can now leave the house and attend meetings without needing the permission of their husband or mother-in-law. Moreover, empowered by the information they have absorbed about pregnancy and childbirth, they have some leverage in family discussions.

“They tell their husbands that if they want a healthy baby … the mother has to eat well. If they aren’t given fish or meat, they drink two glasses of milk instead. And they insist on a hospital delivery,” said Gupta.

In the past, tradition has dictated that women wait for a priest to announce an auspicious moment to start breast-feeding the newborn. While waiting, often for up to three days, they fed goat or cow milk to the baby, causing diarrhoea. “Now we breastfeed at once. We don’t wait for the priest,” said one of the mothers, Kanti Devi.

Seema Agrahari’s three children, now six, three and one, were all delivered in hospital. “I had an IUD for my family planning. It’s the best thing I did. I felt well during each pregnancy,” she said. “But I could have been one of those who died in childbirth. Information saved me.”

This article is part of a series on possible solutions to some of the world’s most stubborn problems. What else should we cover? Email us at theupside@theguardian.com

guardian.co.uk © Guardian News & Media Limited 2010

Published via the Guardian News Feed plugin for WordPress.

Print Friendly, PDF & Email

Leave a comment

'We no longer die in childbirth': how Indian villages saved their mothers | NORTH INDIA KALEIDOSCOPE

Rajesh Ahuja

I am a veteran journalist based in Chandigarh India.I joined the profession in June 1982 and worked as a Staff Reporter with the National Herald at Delhi till June 1986. I joined The Hindu at Delhi in 1986 as a Staff Reporter and was promoted as Special Correspondent in 1993 and transferred to Chandigarh. I left The Hindu in September 2012 and launched my own newspaper ventures including this news portal and a weekly newspaper NORTH INDIA KALEIDOSCOPE (currently temporarily suspended).